Healthcare Provider Details

I. General information

NPI: 1578665550
Provider Name (Legal Business Name): MID - AMERICA HEARING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 W HAYWARD DR
MOUNT VERNON MO
65712-6329
US

IV. Provider business mailing address

1050 W HAYWARD DR
MOUNT VERNON MO
65712-6329
US

V. Phone/Fax

Practice location:
  • Phone: 417-466-7184
  • Fax: 417-466-4081
Mailing address:
  • Phone: 417-466-7184
  • Fax: 417-466-4081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: JOHN SCOTT GEORGE
Title or Position: CEO
Credential:
Phone: 417-466-7184